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There are potential obstacles and risks associated with surrogacy, including complications from ART procedures such as IVF and insemination, its high cost, legal complexities and possible snags, and the often intricate contracts and arrangements involved. Surrogacy can also be emotionally intense and risky for both parties, and there is always the chance that the carrier will change her mind and try to retain custody of the baby. The intended parents and the carrier may also have conflicting opinions on issues such as genetic testing, how the pregnancy should progress, and how the baby should be delivered.

Surrogacy can be an expensive process, with costs averaging between $28,000 and $45,000. The fees include the cost of fertility clinics, lawyers, prenatal care, agencies and/or egg donor fees, as well as the fee to the carrier. An independent adoption is generally less expensive, and gestational surrogacy usually costs more than traditional surrogacy because of the more complicated medical procedures involved.

Some of the controversy surrounding surrogacy stems from ethical and moral issues and the motivations and trustworthiness of the carriers. Many people believe carriers are prompted by materialistic motives or are exploited by the intended parents. In addition, much of the media reporting on surrogacy has focused on arrangements that have gone sour in which the carrier has refused to surrender her parental rights and the baby after birth. However, studies have found that most carriers have an emotional reason for becoming involved, rather than a financial one. Many feel that it fulfills their biological function and their desire to be pregnant, they feel empathy with the infertile woman, or they simply wish to enable others to experience parenthood. While money is a consideration for some, and many potential carriers are emotionally unfit to undergo surrogacy, the drama and conflict often portrayed in the media is not the norm and most surrogate arrangements are successful.

If you are considering surrogacy, there are many organizations that can provide information, advice, encouragement, and can even help connect you with potential carriers. The American Surrogacy Center, Inc., All About, and Surrogate Mothers Online, Inc. provide online forums, chat rooms, and support groups for intended parents as well as carriers.

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